Could virtual reality become a treatment reality for lazy eye patients?

A clinical trial, published in BMC Ophthalmology, investigating the visual outcomes of patients undergoing lazy eye treatment with the Oculus Rift virtual reality headset has shown positive results. This blog post further explores the concept of video games for lazy eye treatment and discusses this published clinical trial in detail.

Although 2018 is in full swing, there is still time to take a look back at one of 2017’s most talked about publications in BMC Ophthalmology. Video games have always been a popular talking point, be it in social circles, the media and even scientific research. Researchers have been weighing out the pros and cons of video games for many years now, which have contributed to the concept of their potential use for treatments.

Amblyopia is often described as a reduction of vision in one eye due to the brain and the eye failing to co-operate.

In recent years, researchers have started to explore the use of video games in the treatment of amblyopia, more commonly known as lazy eye. Amblyopia is often described as a reduction of vision in one eye due to the brain and the eye failing to co-operate. To compensate, the brain will favour the other eye. This can be caused by visual deprivation due to eye conditions that limit the sight from one eye.

Treatment for amblyopia often includes the use of an eye patch or eye drops that ‘blur’ the vision in one eye to encourage the use of the less favoured (amblyopic) eye. However, studies have suggested that this type of treatment is mostly effective in children up to 7 years of age.

Video games as treatment

More recently, alternative approaches, such as dichoptic visual training and video games have been considered. Researchers have studied the effect of engaging with video games on both adult and child amblyopia patients. Studies such as these were conducted using games consoles, PCs or the use of iPads, with some promising results.

In their clinical trial, Žiak et al. have incorporated the use of the popular Oculus Rift headset with dichoptic visual training, which involves the presentation of high contrast stimuli to the amblyopic eye and low contrast stimuli to the favoured eye in an attempt to balance visual input.

A figure taken from Žiak et al’s study showing the Oculus Rift headset and a LCD screen which shows what the participant is seeing.

In the study, 17 adult participants with amblyopia were given dichoptic visual training via Oculus Rift headsets and the Diplopia Game which was developed by Vivid Vision. The patients had a choice of a space game, in which the user had to guide space ship through rings in an obstacle course, and a block breaker game.

Each game was designed to include a “dichoptic setting” which combined the concept of dichoptic visual training with the objectives of the game. In the space game the colourful intergalactic obstacles were only presented in the amblyopic eye, whilst the spaceship was only presented in the favoured eye, which stopped the patients “cheating” by closing one eye.

A figure taken from the paper by Žiak et al’s study, demonstrating the “dichoptic setting” in the space game that was played by the participants.

The preliminary results from this study showed that there was improvement in the amblyopic eyes of some the participants. Žiak et al. demonstrated that the application of dichoptic visual training using a virtual headset such as the Oculus Rift is a potentially useful treatment for amblyopia. Furthermore, these preliminary results provide a stable premise for future research into alternative treatments for amblyopia and the clinical use of virtual reality.